Health Care policy for Baltimore platform for Cindy Walsh for Mayor of Baltimore

My platform for health care centers on installing a public health system in Baltimore modeled on Expanded and Improved Medicare for All

Maryland and Baltimore has one of the most private and profit-driven health systems in the nation. Maryland sought and received questionably the exemption from Medicare requirements for three decades under the guise of creating a private system that would be more efficient and effective. Three decades later we see the results----Baltimore, where these policies would hit the hardest as the largest county receiving Medicare and Medicaid funding especially for low-income saw longevity and health outcomes fall to last in the nation and International Health Justice organizations placed Baltimore as third world in its public health outcomes. This occurred because of this private health system that pools all Medicare and Medicaid funds for the state and then distributes them according to a block grant system with no attention paid to the requirements that Federal funds for our public trusts be distributed equally and without discrimination. This is why an exemption allowed for Maryland like this---placing Maryland citizens at unequal disadvantage to citizens across the nation was not what Rule of Law allowed. That said, we see the results of a distribution pattern everyone knows after 3 decades was indeed extremely discriminatory according to race and class.Moving forward from these policies comes an Affordable Care Act that seeks to further break down our Federal health programs Medicare and Medicaid with deregulation, consolidation, and formation of a managed care process that has broad public outcry----from citizens across political spectrum, professionals in the health care industry, justice organizations, and world health organizations. These policies are so important around the world because they are tied to a Trans Pacific Trade Pact that seeks to build public health policies in nations signing to this agreement. The Affordable Care Act was our Congress and our President’s attempt to meet the guidelines of this TPP agreement which absolutely no citizen is aware of contents and no citizen has given approval. We understand Congress again thinks it has the power to Fast Track TPP and to move forward with an Affordable Care Act with policies no citizen again was asked to contribute. As both Republican and Democratic citizens work to reverse the damage done to what was the best in the world public health system whose only fault was the health industry fraud and profiteering that created conditions for soaring costs. This became a problem during the Reagan/Clinton dismantling of oversight and accountability under a policy of SMALL GOVERNMENT that all now no failed the American people miserably.

This said, to stop and reverse the damage of a dismantling of our strong, public health system with its New Deal and War on Poverty Federal funding and public interest health structures that kept the American people safe, well-serviced with the best professional health care in the world, we will rebuild the public health structure at the US city-level as in Baltimore using the best in the world Medicare Administrative system of distribution, oversight, and management. One health system doing what Affordable Care Act makes into an outsourced, unaccountable, profit-driven managed care system with goals of building global systems unattached to our American ideals of Western medicine-----Hippocratic Oath, Do No Harm, Patient’s Bill of Rights, Equal Protection, and citizens legislating for public interest in VALUE-ADDED AND EVIDENCE-BASED DATA.

EXPANDED AND IMPROVED MEDICARE FOR ALL is an easy structure to build because this is the structure already in place. The idea is to take what was a powerful health structure for our seniors and expand it to all citizens regardless of age. We say Improved because in the course of creating this Affordable Care Act almost a $1 trillion was cut from these health budgets and many changes to existing laws need to be reversed to restore those health protections listed above.There are many models for Expanded and Improved Medicare for All -----Baltimore needs that proposed by social Democrats and that is based upon rebuilding the public hospital/public clinic that is our Baltimore Public Health Department. Every community in Baltimore needs a public health clinic and mental health clinic attached to serve as the core for all public health activities in that community. This will be the oversight and accountability not only in the movement of revenue through the system, but is assessing and providing long-term data of public health programs past and future. A database would allow for the tracking of citizens in these systems, across agencies, including our public K-12 to give a dataset that allows for health outcome pictures per community to be posted to the public with audits done monthly to assure quality control and with annual reviews of all monthly audits to identify problems and make changes for effectiveness and efficiency. Having staff in each public health clinic who can then meet with citizens having that inter-agency assessment allows for that citizen to feel connection with all other agencies with which he/she is tied.This public structure is not meant to replace our non-profits that wish to partner in helping to provide service, it merely allows for continuous assessment of successes on programs and eliminates repeated policies shown to be ineffective. Most important is the need to hire locally in each community citizens working with citizens as that allows a familiarity of community that translate to patients feeling they have long-term connections with care-givers.We have seniors needing public nursing homes and long-term care facilities because we all know a privatized, profit-driven system will not provide a quality of care that comes with Patient’s Bill of Rights. Knowing most seniors today have paid decades of payroll taxes to assure this kind of care----Baltimore has this obligation to meet the terms of Medicare as written. As well, with corporations and businesses feeling the burden of Affordable Care Act and rising health costs and insurance premiums, Expanded and Improved Medicare for All removes the burden of business health plans as everyone is in---no one out. The long-term unemployed and disabled often have work histories for decades before becoming disconnected from the workplace as do pensioners and we need to recognize those revenue contracts. Expanded and Improved Medicare for All removes all that burden of public sector health benefits and the constant concerns of fiscal constraints on city budgets.The Affordable Care Act made clear that these health systems were about creating profit-driven systems that could exclude according to insurance design and managed care protocol. It also sees these health system corporations expanding, marketing their BRAND nationally, globally and installing telemedicine and health tourism as corporations COMPETE for consumers. This means we need to tax these institutions as Johns Hopkins and MedStar for example are now health corporations---Hopkins a global corporation. When Medicare and Medicaid funds are combined and those taxes from for-profit health corporations are added, we are well on our way to funding this system. Remember, Baltimore has lots of health infrastructure needing to be upgraded and re-purposed and lots of partnerships with non—profit hospitals that can be made so physical facilities will not be overly burdensome on finances. As we rebuild all surrounding communities those development funds will include public structures like these clinics and public hospitals.Baltimore and the US has plenty of doctors and medical staff being displaced by Affordable Care Act and its managed care format. Many don’t want to be part of a managed care system; others don’t want to work in a deregulated system where third parties are determining health protocol based on corporate profit. This public system will attract and employ many old and new workers and allow Baltimore citizens the ability to choose to remain in the quality of care and patient safety that comes with regulated health care with oversight and accountability and equal opportunity and access.

Thank you,

Cindy Walsh for Mayor of Baltimore

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As mentioned, in follow up to the forum, we will develop a candidates' guide and plan to distribute to our members and other interested parties your responses to the following:

Give a brief biographical statement.

I have science and M ed degrees from Virginia Commonwealth UniversityI held profession employment in all areas of medicine. Medical College of Virginia laboratory operations, Emergency Medical Technology structures from ambulance to emergency rooms---I worked numerous public health justice platforms from low-income, senior, AIDS, drug addiction, and mental health venues in communities. I managed data-operations for a national NIH/NCI clinical trial with a responsibility of creating operational systems with oversight and accountability, implementing them, and data collection for a multi-city multi-agency 200,000 patient study. I had the opportunity in an unrelated field to develop great Industrial Engineering skills with United Parcel Service that will be key in rebuilding Baltimore City Hall and creating value-added public health and data for all citizens in Baltimore.

What is the single most critical health care or medical concern facing Baltimore AND how will you address it should you be elected Mayor?

The Affordable Care Act is a Republican health policy to end public health, deregulate our public health system, consolidate and create global health systems that will be just as profit-driven and with no oversight and accountability as our past Wall Street reform. This means eradication of Western medical philosophy present for a thousand years and our US first world status of quality care, affordable and equal access care, and the system of oversight and accountability that assured the American people health care procedures, devices, and PHARMA were safe. This means cities like Baltimore must REBUILD that public health system using the Baltimore Public Health Department to see an expansion of public health clinics in each community; public hospital facilities some partnered with our charity hospitals; aging patient care and residential housing; and our public mental health facilities in each community. When we have that public system in place we have created the safety net for citizens unable to meet the rising health care costs we all know are coming. As well, I do not see telemedicine as a vehicle to cheapened health care to ultimately be a citizens’ only vehicle to access. I see telemedicine as its early invention----as a choice for those too sick, to aged, or too disabled to come into regular office visits. I will not replace our public health structures for telemedicine unless warranted. There are many doctors and medical professional not wanting to be part of the current health reform structures or have been pushed out for whatever reason. We will welcome all professionals qualified and we will subsidize medical school and training making the pathway towards being a General Practitioner affordable and open to all qualified increasing our MD presence.

Baltimore City Medical Society (BCMS) is the membership organization of physicians representing all specialties and practice settings, including, solo, group, public health and academic. How might BCMS be of assistance to you and your administration, should you be elected Mayor?

All American professional societies are feeling these reform changes taking the US from a first world status to more of a third world as regards lowered standards, lower access, and lowering of salaries and wages. That said, some will seek to profit and enjoy the competitive nature of this global corporate health tourism/system and some, like me, will want to maintain our US standards of quality and professionalism. That is to where BCMS will fall. I do not believe all members of AMA or BCMS are that profit-driven professional and there will be plenty of connections needed within this existing community in building this public structure and I hope you will join me as we create choice and options for all citizens in Baltimore.

Please submit (via a response to this e-mail) your complete responses no later than 5:00 p.m., Friday, March 25, 2016. We reserve the right to edit all responses, as appropriate. You will receive a copy of the guide.Thank you.

Thomas E. Hunt, Jr., M.D., ChairmanAllan D. Jensen, M.D., Treasurer

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